Featured Research

from universities, journals, and other organizations

Early Mobilization Of Patients In ICU Improves Outcomes

Date:

May 17, 2009

Source:

American Thoracic Society

Summary:

Aside from the obvious and immediate health problems that patients undergoing mechanical ventilation face, those who recover often do so with profound loss of strength and mobility that can impair their daily functioning and even lead to increased risk of morbidity and mortality down the line. Now research shows that functional status may be restored earlier to ICU patients by performing daily interruptions in sedation paired with mobilization and exercise, as led by physical and occupational therapists.

Share This

Aside from the obvious and immediate health problems that patients undergoing mechanical ventilation face, those who recover often do so with profound loss of strength and mobility that can impair their daily functioning and even lead to increased risk of morbidity and mortality down the line. Now research shows that functional status may be restored earlier to ICU patients by performing daily interruptions in sedation paired with mobilization and exercise, as led by physical and occupational therapists.

Related Articles

The study results will be announced on May 17 at the 105th International Conference of the American Thoracic Society in San Diego.

"Weakness and loss of functional independence—the inability to transfer from bed, walk and execute typical daily self-care activities, such as cleaning and dressing oneself—are commonly experienced among patients discharged from the intensive care unit," said William Schweickert, M.D., assistant professor of medicine in the Pulmonary, Allergy, and Critical Care Division at the University of Pennsylvania Medical Center. "This can result in major disability and protracted rehabilitation and may be accelerated or exacerbated by prolonged periods of immobility, especially among patients who undergo mechanical ventilation and sedation."

"Because ICU-acquired weakness is associated with such poor outcomes and potentially exacerbated by deep sedation and immobility, we wanted to see whether mobilization begun in the earliest days of respiratory failure would improve patient function at hospital discharge and reduce delirium," he continued.

Dr. Schweickert and colleagues conducted a randomized trial of 100 patients who were undergoing sedation and mechanical ventilation in the ICU. They compared patients who underwent a protocol of daily mobilization in conjunction with sedative interruption with those who underwent sedative interruption alone and therapy services as ordered by their primary care team.

They found that patients who underwent the mobilization protocol were more frequently able to get out of bed, stand and occasionally walk with assistance during mechanical ventilation. The physical regimens prescribed by the primary care team, on the other hand, often began only after mechanical ventilation was no longer needed, potentially leading to a longer loss of functional status and a longer recovery time.

The degree of functional loss in the control arm was substantial—only one third of patients left the hospital able to function independently. In contrast, nearly 60 percent of the early mobilization patients had achieved independence.

"Overall, patients in the mobilization group were nearly twice as likely to regain their functional independence at hospital discharge and experienced less delirium than did their counterparts who did not receive the intervention," said Dr. Schweickert.

"The benefits of pairing mobilization and sedative interruption from the inception of critical illnesses are substantial, but the improvements in function are not easily recognizable until about two weeks," observed Dr, Schweickert, adding that "starting these therapies early can be difficult in the context of ongoing critical illness, yet the data highlights that it can be done safely. We still need to test how this intervention and its findings translate into longer-term survival and better quality of life."

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Mar. 31, 2015  A drug being developed to treat osteoporosis may also be useful for treating osteogenesis imperfecta or brittle bone disease, a rare but potentially debilitating bone disorder that that is present ... full story

Mar. 31, 2015  It is possible to quantify and classify the effects of different diseases on the activity of intestinal bacteria, new research demonstrates for the first time. Human intestinal flora, known as ... full story

Mar. 31, 2015  During prenatal development, the brains of most animals, including humans, develop specifically male or female characteristics. But scientists have known little about the details of how this ... full story

Mar. 31, 2015  A history of depression may put women at risk for developing diabetes during pregnancy, according to research. This study also pointed to how common depression is during pregnancy and the need for ... full story

Mar. 31, 2015  Women who are abused by their partner or ex-partner are much less likely to use contraception; this exposes them to sexually transmitted diseases and leads to more frequent unintended pregnancies and ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Oct. 17, 2012  For critically ill patients receiving mechanical ventilation, daily sedation interruption did not reduce the duration of mechanical ventilation or appear to offer any benefit to patients, and may ... full story

May 17, 2010  Electrical muscle stimulation (EMS) can prevent critical illness polyneuromyopathy (CIPNM), according to Greek researchers. CIPNM is an acquired limb and respiratory muscle weakness that is a common ... full story

May 10, 2010  Patients who are critically ill and participate in mild exercise programs led by physical therapists achieve higher functional mobility and spend fewer days in intensive care units (ICU) and ... full story

Apr. 9, 2010  A new report from critical care experts shows that use of prescription sedatives goes down by half so that mild exercise programs can be introduced to the care of critically ill patients in the ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.